I got a call from a former student of mine who now works at a hospital. She is a critical care medic, and is actually one of the most knowledgeable medics that I know. Her problem? She frequently gets told that her opinion doesn’t count and she doesn’t know what she is talking about because she has only been a medic for two years. We will refer to her as CC medic. Case in point:

First problem

A female patient enters the ED, where this medic is working. She is a 54 year old woman of African descent, and has a pretty severe case of angioedema:

She has a history of hypertension, and is taking Lisinopril HCTZ. There is no other history, and patient denies having any allergies. The ED staff flips their shit, and begins prepping for intubation. The doctor is ordering epinephrine and Benedryl.
CC medic says that this is likely a bradykinin initiated angiedema, brought on by the ACE inhibitor. She tells them that being a bradykinin initiated edema, it will not respond to epinephrine or to histamine blockers. One of the other medics working there, who we will call Old Medic, has more than a decade of experience, tells her to be quiet. He tells her that she is too young to know what she is talking about, and then tells her that “this is obviously anaphylaxis” and to just be quiet and learn. So my medic friend gets mad, says whatever, and leaves the room.
The doctor, seeing how agitated she was, took the time to think about what she said, looked it up, and agreed that she was correct.

Second problem

That same night, a patient had been sedated, chemically paralyzed, and intubated. CC medic notices that the sedation has worn off, and the patient is now awake and has tears in her eyes. She remembers that I taught her that the worst thing to see in an intubated, paralyzed, supposedly sedated patient is tears. (think about how cruel it is to have a tube down your throat and be unable to move, tell anyone, shout for help, or even blink, but be completely awake)
She advocates for the patient by asking for more sedation, and the RN says that she is too busy helping 4 other nurses give tPA to take care of her patient. Old Medic comes over and gives her a speech about how it isn’t within her scope of practice or job description to worry about patients like this, and that she should just mind her own business. The patient did finally get sedated again, but it was 5 minutes later. 5 minutes of being paralyzed and aware of everything. How terrifying and uncaring!

I didn’t realize that caring about your patients and advocating for their well being is wrong and not part of a paramedic’s job description.

Some people have 5 years of experience, and others have a year of experience repeated 5 times. Just because you have been on the job for years doesn’t mean that you have nothing to learn, and doesn’t mean that a newer medic doesn’t know something that you do not, and just because you have never heard of something, doesn’t mean that it doesn’t exist.

Just sayin’.

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